Marica Shava Tipton, PH.D.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4775-125 Issued in WI

Practice address

2125 Derrin LN
Brookfield, WI 53045-2151

Phone

(414) 297-7745

Fax

(262) 641-9768

NPI assigned

Jun 16, 2008

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. Marica Shava Willson-Tipton Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eulopia Family Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brookfield, WI
  • NPI 1427838242
  NPD Authorized official
• Eulopia Family Services, Inc.

  • Community/Behavioral Health Agency
  • Brookfield, WI
  • NPI 1447410154
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1467612168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2125 DERRIN LN",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452151",
            "telephone_number": "414-297-7745",
            "fax_number": "262-641-9768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2125 DERRIN LN",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530452151",
            "telephone_number": "414-297-7745",
            "fax_number": "262-641-9768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPTON",
        "first_name": "MARICA",
        "middle_name": "SHAVA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-16",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "4775-125",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43715200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARICA",
            "last_name": "WILLSON-TIPTON",
            "middle_name": "SHAVA",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Gina L Tieman
• Marina Clarice Tierney, PSY.D.
• Shaquilla Tillman Tomlinson
• Rachel M Tillman, LPC
• William D Timm, MD
• TMNS, LLC
• TMS Wellbrook Brookfield LLC
• Tobin J. Strupp DDS LLC
• Keely Toboyek, BCBA
• Elizabeth Tollenaar

• Professional Counselor in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.